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Socio-cultural INFULENCES AND Access TO Basic Obstetric Care (BOC)
Although pregnancy and childbirth are not of medical origin, respectively, they signify normal physiological events. Women who are pregnant often anticipate satisfactory childbirth outcomes, with no complications during the birthing process. Maternal and Child health is achieved through comprehensive obstetric interventions. While basic obstetric care is available for pregnant women, socio-cultural beliefs are effective as well to convince them not to access appropriate care during obstetric emergencies. Therefore, this essay explains why pregnant women are often unable to receive care they need and the benefits of accessing essential obstetric care in health facilities.
Socio-cultural Beliefs and Childbirth Practices
Whilst there are many cultures throughout the world, every culture is distinct and varies considerably from one another. Culture is viewed as a main pillar that clearly defines ethnic identity, autonomy, and the tribal dominance of a society (Bravo & Noya, 2014). Its influence is fascinating by the way certain skills, knowledge, and practices are observed and learnt over a period of time to maintain and preserve its existence (Sherry & Ornstein, 2014).
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Similarly, different societies have profound cultural beliefs and interpretations in relation to pregnancy and childbirth practices. Though birthing is an individual occasion, it is also an important societal experience that impacts women’s perceptions and certain beliefs between respective societies (Kaphle, Hancock, & Newman, 2013). For instance, during pregnancy, women strictly observe their cultural norms and “taboos” by avoiding certain foods or diets. In general, a particular food that is abundant in protein is avoided due to their mutual belief(s) that may lead to congenital deformed babies, resembling features of food eaten, or their babies may grow big thereby complicating the second stage of labour (Kuzma, et al., 2013). Cultural influences are persuasive, and thus, prevent pregnant women to access essential maternal health care.
Socio-cultural Beliefs and Access to Basic Obstetric Care (BOC)
In spite of the fact that there are many different societies, they are often classified into two broad kinds of societies; patrilineal or matrilineal. Patrilineal society is more common and influential. Patrilineal societies qualify men to own the land, properties, make critical decisions, and decide on family size (Koian, 2010). Land is considered as an important asset for families in ethnic societies. This is why, in patrilineal societies, men would often want to have more male children in their family to inherit the land, and also to take full responsibility during their old age (Tao, 2014). In contrast, women’s responsibilities are often associated with domestic duties, such as cooking, gardening, childbearing and childrearing.
On the other hand, basic medical ailments and maternal health services (for example, Family Planning) are viewed as insignificant to certain societies, and are perceived to only interfere with their cultural beliefs (Kaphle, Hancock, & Newman, 2013). Moreover, any pregnancy or childbirth-related complications are considered abnormal, and the victim (pregnant woman) is condemned for disobedience; as a result, she is cursed by ancestral evil forces (Kuzma, et al., 2013). Such cultural beliefs often have subsequent impact on pregnant women accessing and utilising vital antenatal and obstetric care (Boerleider, Wiegers, Mannien, Francke, & Deville, 2013).
Traditional Birth Attendance (TBA) and their Experiences
To strengthen maternal health care, emphasis is placed on pregnant women accessing health facilities for supervised care and deliveries from Skilled Birth Attendants (SBAs). These are qualified health professionals (such as; midwives, nurses and doctors) who are able to manage pregnancies and childbirths, and detect possible obstetric complications threatening to the mother and her unborn baby (Uzt, Siddiqui, Adegoke, & Broeke, 2013).
In many societies, Traditional Birth Attendants (TBAs) are available, usually old women who are considered skilful and knowledgeable in managing childbirths. Their competency of practice has become women’s first choice of contact when in labour. Also, their respectful approach toward mothers, irrespective of their social status, age, parity, and reasonable labour fees, have continued to influence women’s perception of positive childbirth experiences under their care (Akpabio, Edet, Etifit, & Bassey, 2014).
Unfortunately, TBAs still require essential evidence-based knowledge; they need adequate emergency obstetric skills and kits to manage during labour and birth emergencies. Their performing (birthing) roles were observed, and acquired only through other experienced TBAs. Yet, pregnant women still forgo formal deliveries to seek assistance from TBAs. Even some who often attend antenatal clinics still prefer TBAs during labour. Such care outside the scope of professional practice results in high rates of preventable maternal deaths (Akpabio, Edet, Etifit, & Bassey, 2014). Pregnancy and childbirth experiences can be life-threatening without the presence of SBAs. Hence, it is necessary for pregnant mothers to seek formal support, and care in health care settings where health care providers, and essential life-saving equipment are available.
Health Care Providers’ Attitudes and Approaches
Health Care Providers have primary responsibilities in providing health care effectively to their patients (women) without favouritism, injustice, harassment, and discrimination due to their socio-cultural attributes. One of the reason that affects pregnant women in relation to seeking a health centre birth is the “maltreatment” they receive from health care providers. Such unethical treatment in general includes professional negligence, abusive language, discrimination, and interventions without granting permission (Moyer, Adongo, Aborigo, Hodgson, & Engmann, 2014). They feel that the environment is not conducive for them. Thus, the fear of ill treatment from health care providers (especially, midwives and other female health workers) often discourages women from accessing health care to deliver their babies (Essendi, Mills, & Fotso, 2010). The attitudes and approaches of health care providers must be facilitated in such a friendly manner so as to encourage midwife/nurse-to-mother relationships to achieve optimal maternal outcomes.
Another reason that often prevents pregnant women opting for hospital births is their fear of health workers’ keeping their placentas for disposal (without giving the placentas to them). Some women often use placentas to execute traditional ceremonials, and are concerned it will be difficult for them to take their placentas home. Such deprivation becomes a hindrance for some of them to access supervised delivery where appropriate and essential (Moyer, Adongo, Aborigo, Hodgson, & Engmann, 2014). For that reason, establishing rapport and providing empathetic care and a compassionate attitude is expected. Transcultural conflicts in health are precluded when care is integrated harmoniously without cultural interference.
In conclusion, the emphasis on facilitating obstetric services for pregnant women performs an essential role in strengthening maternal and child health. Improving accessibility and reinforcement at all levels of the health care system is of paramount importance for obstetric services to function effectively. Professional conduct during the care is needed while as much as possible, accommodating socio-cultural attributes to attain best possible outcomes. Also, comprehensive community-based programs by health care providers relating to maternal health, has the potential to connect any existing socio-cultural barriers, and allow women to freely utilize obstetric care when necessary.
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